HEALTH surveillance is the generic term used to describe checks undertaken on workers who may be affected by conditions or substances they are exposed to during employment.
In instances when it is anticipated that an individual may suffer adverse health due to the work they do, or their place of work, health surveillance is needed.
In the oil and gas industry, which is a core industry for the north-east of Scotland, statutory health surveillance is required for workers as they could be exposed to specific hazards where overexposure has serious health consequences.
Working with lead, asbestos and ionising radiation are further examples where workers are being exposed to hazardous materials.
In addition, the Noise at Work, the Control of Vibration at Work and Control of Substances Hazardous to Health (COSHH) regulations specify when health checks would be appropriate for other workers exposed to specific hazards. Whatever the risk, the purpose behind the programme is to protect workers, either through identifying those who are particularly vulnerable to a known condition or through the early identification of a condition.
Increasingly, a tiered approach is used for non-statutory health surveillance, with questionnaires used as an initial screen to identify those with symptoms requiring further assessment from those with no reported symptoms.
Where further assessment is required, this will be determined by the health effect being measured.
Some examples include:
Skin inspections for those working with substances likely to cause dermatitis.
Lung-function tests for those exposed to respiratory irritants.
Hearing tests for workers exposed to noise above set levels.
Neurological and circulation tests for workers exposed to vibration sources.
Biological sampling of blood or urine for chemical levels or effects – for example, benzene.
Health surveillance tests can be carried out by anyone with suitable training.
In a small proportion of cases identified, the final outcome will rest with the occupational-health doctor in regard to diagnosing an occupationally related health condition. This may require further investigation to exclude other possible causes of the symptoms.
With the hierarchy of controls used by employers to protect their employees, health surveillance sits at the end of the chain as a final check and as a feedback measure to establish that other control measures have been effective.
While clinical data in a health-surveillance programme remains confidential, a health record is not, and is retained by the employer.
The health record contains information regarding individual employees’ fitness or whether they have been categorised with a health condition.
Collating and analysing anonymous data from employee health records has been made easier since the introduction of computerised health surveillance questionnaires and systems.
Dr Allan Prentice is lead clinician at Capita Health Solutions and is a member of the Faculty of Occupational Medicine.